Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 574 | CT |
N | 111NP0017X | Pediatric Chiropractor | 574 | IA |
NPI | 1144511205 |
---|---|
Provider Name | Laura Virginia Nunno |
First Address | Cromwell, CT 06416-2633 |
Second Address | Cromwell, CT 06416-2633 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2011 |
Last Update Date | 25/04/2011 |